Maternal Mortality; Fear from Centuries Past Still Grips Parts of world.(NATION)(CULTURE, ET CETERA)

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Byline: Cheryl Wetzstein, THE WASHINGTON TIMES

One of the "greatest miracles" in the past century for American women is the likelihood they will give birth safely.

Even as late as the 1930s, American women had a pervasive and legitimate fear of dying in childbirth.

"How soon, my Dear, death may my steps attend. How soon't may be thy lot to lose thy friend," 17th century New England poet Anne Bradstreet wrote in the dread-filled days before the birth of one of her children.

"Died in childbirth" was a likely epitaph for one in eight mothers in Colonial days, says the Gilder Lehrman Institute of American History in New York City. Common lethal complications included massive blood loss, infection, convulsions, obstructed labor and dehydration.

Now strict sanitation laws, antibiotics, blood transfusions, prenatal monitoring for life-threatening complications and other medical advancements have brought U.S. maternal mortality to a record low of 7.1 deaths per 100,000 live births.

"This may be one of the greatest miracles of the 20th century" for American women, said Janice Shaw Crouse, senior fellow at the Beverly LaHaye Institute: A Center for Studies in Women's Issues.

"Today, women prepare for childbirth by painting a nursery; in an earlier age, they wrote heart-wrenching goodbye letters to loved ones in case they did not survive childbirth," she said.

The United States is one of about 20 countries with maternal mortality rates of fewer than 10 deaths per 100,000 live births. U.S. officials want the rate to go lower - to 3.3 deaths per 100,000 live births - by 2010.

However, maternal mortality continues to destroy families in dozens of countries.

The World Health Organization has identified 23 nations in which the maternal death rate is greater than 1,000 per 100,000 births. Rwanda has a staggering 2,300 deaths per 100,000 births.

"It is no exaggeration to say that the issue of maternal mortality and morbidity, fast in its conspiracy of silence, is the most neglected tragedy of our times," editor Peter Adamson wrote in a scathing UNICEF report, "The Progress of Nations 1996."

About 600,000 women die each year, he said, including an estimated 140,000 who die while "violently pumping blood onto the floor of bus or bullock cart or blood-soaked stretcher as their families and friends search in vain for help."

Mr. Adamson recommended that all birth attendants be trained "to do no harm" - for example, to not touch mothers with unwashed hands or use unsterilized knives. Birth attendants and fathers-to-be also should be educated to recognize warning signs in a pregnancy so women can be brought to medical centers in time to save them, he said.

Developing countries must provide more emergency obstetric-care facilities with basic equipment and drugs, said Dr. Allan Rosenfield, dean of the Mailman School of Public Health at Columbia University in New York and a specialist on maternal mortality.

Prenatal and preventive care aren't enough, by themselves, to reduce maternal mortality, Dr. Rosenfield said. …